Methods and devices for preparing and implanting tissue scaffolds

Abstract

Methods and devices are provided for preparing and implanting tissue scaffolds. Various embodiments of scribing tools are provided that are configured to mark one or more predetermined shapes around a defect site in tissue. The shape or shapes marked in tissue can be used to cut a tissue scaffold having a shape that matches the shape or shapes marked in tissue. In one embodiment, the scribing tool used to mark a shape in tissue can also be used to cut the tissue scaffold.

What is claimed is: 
     
       1. A tissue repair kit, comprising:
 a scribing device having first and second handles and having first and second elongate shafts, each of the first and second shafts having a lumen extending therethrough, the first shaft extending from the first handle, and the second shaft extending from the second handle, the second shaft extending through the lumen of the first elongate shaft with a distal end of the second shaft being located outside of the lumen of the first shaft and being aligned with a longitudinal axis of the first elongate shaft, and a scribing element formed on a distal end of the first elongate shaft, the scribing element extending along an axis that is offset from the longitudinal axis of the first elongate shaft, and the scribing element having a distal-most scribing edge that is curved such that rotation of the scribing device about the longitudinal axis of the first elongate shaft is effective to cause the scribing edge to form a circular mark in tissue; and 
 a biocompatible tissue repair scaffold configured to be implanted in a defect site in tissue. 
 
     
     
       2. The tissue repair kit of  claim 1 , wherein the scribing element is configured to form the circular mark in the tissue by cutting through the tissue without significantly cutting bone underlying the tissue. 
     
     
       3. A surgical method, comprising:
 advancing a surgical device into a body of a patient to position a distal scribing tip of the device at a defect site in tissue; 
 rotating the surgical device about a central longitudinal axis of the surgical device such that the distal scribing tip rotates to form a circular mark in tissue around the defect site; 
 removing the tissue within the circular mark by suctioning the tissue through the surgical device to form a circular cavity in the tissue; 
 cutting a biocompatible tissue repair scaffold to have a circular shape that corresponds to the circular mark formed in the tissue; and 
 implanting the biocompatible tissue repair scaffold in the circular cavity in the tissue; 
 wherein rotating the surgical device comprises rotating an outer member having the distal scribing tip formed thereon relative to an inner member that engages bone underlying the tissue. 
 
     
     
       4. The method of  claim 3 , wherein the surgical device is inserted through an opening in tissue, and wherein the circular mark has a diameter that is greater than a diameter of the opening. 
     
     
       5. The method of  claim 3 , wherein cutting the biocompatible tissue repair scaffold comprises punching the scaffold with a punch having a diameter that corresponds to a diameter of the circular mark formed in the tissue. 
     
     
       6. The method of  claim 3 , wherein the circular mark has a diameter in the range of about 5 to 40 mm. 
     
     
       7. The method of  claim 3 , wherein the biocompatible tissue repair scaffold has a viable tissue disposed thereon. 
     
     
       8. The method of  claim 3 , wherein cutting the biocompatible tissue repair scaffold includes cutting the biocompatible tissue repair scaffold with the surgical device. 
     
     
       9. The method of  claim 3 , wherein the distal scribing tip rotates to form the circular mark in the tissue around the defect site without forming a mark in bone underlying the tissue. 
     
     
       10. A surgical method, comprising:
 rotating a first scribing device about a longitudinal axis of the first scribing device to form a first substantially circular mark in tissue at a defect site; 
 removing tissue within the first substantially circular mark by suctioning the tissue through the first scribing device; 
 rotating a second scribing device about a longitudinal axis of the second scribing device to form a second substantially circular mark in the tissue at the defect site, the second substantially circular mark partially overlapping the first substantially circular mark; and 
 removing tissue within the second substantially circular mark by suctioning the tissue through the second scribing device to remove a defect in the tissue; 
 wherein rotating the first scribing device comprises rotating a first outer member having a first distal scribing tip formed thereon relative to a first inner member that engages bone underlying the tissue; and 
 wherein rotating the second scribing device comprises rotating a second outer member having a second distal scribing tip formed thereon relative to a second inner member that engages bone underlying the tissue. 
 
     
     
       11. The method of  claim 10 , further comprising forming at least one linear mark in the tissue, the at least one linear mark extending between an outer edge of the first substantially circular mark and an outer edge of the second substantially circular mark. 
     
     
       12. The method of  claim 10 , further comprising forming first and second linear marks in the tissue, each linear mark being tangent to the first and second substantially circular marks such that the first and second substantially circular marks and the first and second linear marks form an oblong mark in the tissue. 
     
     
       13. The method of  claim 10 , wherein removing the tissue within the first and second substantially circular marks forms a cavity in the tissue, and the method further comprises implanting a biocompatible tissue repair scaffold in the cavity in the tissue. 
     
     
       14. The method of  claim 13 , further comprising, prior to implanting the biocompatible tissue repair scaffold, measuring a maximum length of the first and second substantially circular marks formed in the tissue, and cutting the biocompatible tissue repair scaffold to have a size and shape that corresponds to a size and shape of the cavity in the tissue. 
     
     
       15. The method of  claim 14 , wherein cutting the biocompatible tissue repair scaffold includes cutting the biocompatible tissue repair scaffold with the first scribing device and the second scribing device. 
     
     
       16. The method of  claim 10 , wherein the first substantially circular mark has a diameter that differs from a diameter of the second substantially circular mark. 
     
     
       17. The method of  claim 10 , wherein the first substantially circular mark is formed in the tissue and the second substantially circular mark is formed in the tissue without a mark being formed in bone underlying the tissue.